License holder summary

Neville Kallarackel Jacob is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Neville Kallarackel Jacob is 2909 Country Home Road Suite #1, Goshen IN 46526. This licensed professional license is not current. The license was granted 02/25/2010 and expired on 03/01/2012.

Indiana

Professional Licensing Agency

Neville Kallarackel Jacob
Controlled Substance Registration - Dentist
License number
12011408B
Date granted
02/25/2010
Date expires
03/01/2012
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
2909 Country Home Road Suite #1, Goshen IN 46526
indianalicensing.org
ID 5098000
LAST UPDATED 2024-04-02 10:17:44 UTC

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